Credentialing & Payor Enrollment Specialist in United States at Jobgether

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Credentialing & Payor Enrollment Specialist based in the United States.

This role plays a key part in ensuring providers are accurately credentialed and successfully enrolled with insurance payors, directly supporting revenue cycle performance and provider network readiness. You will manage end-to-end credentialing and enrollment workflows, ensuring timely onboarding, accurate provider data maintenance, and compliance with payer and regulatory requirements. The position requires strong coordination across internal teams, external vendors, and insurance organizations to resolve enrollment issues and maintain seamless provider access to payer networks. You will work in a detail-driven, fast-paced environment where accuracy, responsiveness, and follow-through are essential. This role has a direct impact on both financial outcomes and provider experience. It is well suited for professionals who enjoy structured operational work within healthcare administration and revenue cycle management.

• Maintain and update CAQH profiles, ensuring provider data accuracy, timely attestations, and compliance with credentialing standards.
• Manage provider enrollment and credentialing workflows, including onboarding, updates, and ongoing maintenance of provider records.
• Submit and track provider applications through payer portals, ensuring timely processing and resolution of enrollment requests.
• Monitor credentialing timelines, license renewals, and provider updates to ensure all requirements are met without delay.
• Respond to payer requests for information accurately and promptly to support enrollment and verification processes.
• Collaborate with internal teams, external vendors, and healthcare partners to resolve enrollment issues and improve process efficiency.
• Maintain data integrity across systems such as CAQH, NPPES, PECOS, and payer databases.
• Identify and escalate risks, delays, or process gaps to leadership while ensuring timely resolution of outstanding issues.
• Support continuous improvement initiatives by identifying opportunities to enhance credentialing workflows and system efficiency.

• 1–3 years of experience in credentialing, provider enrollment, or healthcare revenue cycle operations.
• High school diploma, GED, or equivalent experience required.
• Familiarity with payer enrollment systems, CAQH, NPPES, PECOS, and state Medicaid portals strongly preferred.
• Strong attention to detail with the ability to manage complex data accurately and efficiently.
• Intermediate proficiency in Microsoft Excel and comfort working with multiple systems and databases.
• Excellent written and verbal communication skills with strong customer service orientation.
• Ability to prioritize tasks, meet deadlines, and manage time-sensitive workflows independently.
• Strong problem-solving skills with a proactive and inquisitive mindset.
• Ability to work both independently and collaboratively in a fast-paced environment.
• Openness to process improvement and innovation, including the use of new technologies.

• Hourly compensation range: $19.75 – $23.50 depending on experience.
• Bonus incentives and annual performance recognition programs.
• Paid certifications and tuition reimbursement to support career advancement.
• Comprehensive benefits package including healthcare, retirement, and well-being programs.
• Remote work flexibility with occasional travel as required.
• Professional development opportunities within a high-performing revenue cycle organization.
• Inclusive, collaborative culture focused on growth, innovation, and continuous improvement.
• Opportunities to contribute directly to provider success and revenue cycle optimization.